Reference to any prior art in this specification is not, and should not be taken as, an acknowledgment or any form of suggestion that this prior art forms part of the common general knowledge in any country.
Reference in this specification to any prior publication (or information derived from it), or to any matter which is known, is not, and should not be taken as, an acknowledgment or admission or any form of suggestion that that prior publication (or information derived from it) or known matter forms part of the common general knowledge in the field of endeavour to which this specification relates.
Bibliographic details of the publications referred to by author in this specification are collected alphabetically at the end of the description.
Waste elimination dysfunction can take many forms. For example, urinary incontinence, intestinal incontinence or constipation can occur.
Treatment systems exist for treating constipation by providing electrical stimulus via subcutaneously implanted electrodes positioned around the lower bowel. Electrical stimulation provided using such electrodes can be used to sequentially activate muscle fibres around the bowel to force a peristaltic action to occur. However, such treatment systems are undesirably invasive. Further, while such systems may have an immediate effect in assisting to evacuate the bowel, they do not necessarily address the cause of the constipation. Importantly, this effect has not been described as long lasting or having an effect beyond the immediate time of electrical stimulation.
Intractable constipation and soiling are extremely common in the community, in both the young and old, and available treatments are generally uncomfortable, can cause social distress for sufferers and are a significant drain on the health care system. Individuals that suffer from constipation and soiling who are young or old may also have psychological issues. In addition, constipation may be a side effect of some kinds of medication, such as opiates. Most laxative therapies are designed to either soften the stool or stimulate the bowel by chemicals in the lumen. Patients with chronic constipation or intractable constipation may have failed other treatment methods including pharmaceutical treatment. Patients on therapies for other diseases in which constipation is a side effect of the medication may not be able to be co-administered pharmaceutical treatments for constipation. Non-invasive, non-drug-based treatment methodologies may be desired in such cases.
Sometimes constipation may be unrelated to diet or medications, and can be due to poor motility in the whole colon (Benninga et al, J Pediatr Gastroenterol Nutr., 23:241-51, 1996; Hutson et al, J Pediatr Surg., 31:580-583, 1996). A newly identified disorder, which is known as slow-transit constipation (STC), is not uncommon amongst children who fail standard medical therapy, and such children often have signs of colonic dysfunction even at birth. (Shin et al, JPediatr Surg., 37:1762-1765, 2002).
Previous electrical stimulation involved non-daily stimulation (i.e. 12 sessions in 4 week period) of short periods (i.e. 20 min of treatment) using transcutaneous devices that have been developed for physiotherapy treatment of muscular injuries (Clarke et al, J. Pediatr. Surg., 44:408-412, 2009.)
It is desired to address or ameliorate one or more disadvantages or shortcomings associated with existing treatment systems, methods or regimes, or to at least provide a useful alternative thereto.